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Case Reports
. 2014 Feb 16;2(2):32-5.
doi: 10.12998/wjcc.v2.i2.32.

Surgical removal of a large mobile left ventricular thrombus via left atriotomy

Daizo Tanaka  1 , Shinya Unai  1 , James T Diehl  1 , Hitoshi Hirose  1
Affiliations
Case Reports

Surgical removal of a large mobile left ventricular thrombus via left atriotomy

Daizo Tanaka et al. World J Clin Cases. .

Abstract

Left ventricular (LV) thrombus is a life-threatening complication of severe LV dysfunction. Ventriculotomy has been a commonly performed procedure for LV thrombus; however, it often further decrease LV function after surgery. We present an alternative approach to thrombectomy in order to minimize the postoperative LV dysfunction. A 37-year-old female with a postpartum cardiomyopathy found to have poor LV function and a large left ventricular apical thrombus (3 cm × 3 cm) attached to the apex by a narrow stalk. Given her severe LV dysfunction, the LV thrombus was approached via left atriotomy under cardiopulmonary bypass. The LV thrombus was easily extracted with gentle traction via the mitral valve. Postoperatively, the patient was discharged home without any embolization event or inotropic support. LV thrombectomy via left atriotomy through the mitral valve could be an alternative option for the patients with poor LV function with a mobile LV thrombus.

Keywords: Atriotomy; Cardiomyopathy; Left ventricular thrombus; Pedunculated thrombus; Surgical thrombectomy.

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Figures

Figure 1
Figure 1
Transthoracic echocardiogram demonstrated a large left ventricular thrombus. It was highly mobile and the risk of embolization was considered to be high.
Figure 2
Figure 2
Postoperative transthoracic echocardiogram demonstrated only minimally remaining mural thrombus.
See this image and copyright information in PMC

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